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Case 17 - A 70-Year-Old Woman with Diabetes, Exquisitely Painful 2 cm Vulvar Ulcerative Lesion, and Subcutaneous Gas on CT Scan

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
University of Alabama, Birmingham
Lisa Keder
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Mayo Clinic, Rochester
Kimberly S. Gecsi
Medical College of Wisconsin
David Chelmow
Virginia Commonwealth University School of Medicine
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In the emergency room, a 70-year-old morbidly obese woman reports she has an ingrown hair on the right vulva. In the past day, it has grown dramatically in size. It is quite painful at rest and exquisitely painful with touch. She denies fever, nausea, or vomiting. Denies sexual activity in the past 10 years. Denies vaginal bleeding, discharge, and itching. Her past medical history is significant for diabetes for the past 40 years, hypertension, and urinary incontinence for which she wears pads. She states her blood sugar was in poor control in the past day or so. She does not smoke or have any other pertinent social history. Her medications include insulin and blood pressure medication. She denies a significant surgical history and had two term vaginal deliveries.

Surgical Gynecology
A Case-Based Approach
, pp. 45 - 48
Publisher: Cambridge University Press
Print publication year: 2021

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